Differential vascular reactivity responses acutely following ingestion of a nitrate rich red spinach extract

Eur J Appl Physiol. 2016 Dec;116(11-12):2267-2279. doi: 10.1007/s00421-016-3478-8. Epub 2016 Sep 30.


Introduction: Inorganic nitrate ingestion has been posited to affect arterial blood pressure and vascular function.

Purpose: We sought to determine the acute effect of a red spinach extract (RSE) high in inorganic nitrate on vascular reactivity 1-h after ingestion in peripheral conduit and resistance arteries.

Methods: Fifteen (n = 15; males 8, females 7) apparently healthy subjects (aged 23.1 ± 3.3 years; BMI 27.2 ± 3.7 kg/m2) participated in this crossover design, double-blinded study. Subjects reported to the lab ≥2-h post-prandial and consumed RSE (1000 mg dose; ~90 mg nitrate) or placebo (PBO). Venipuncture was performed on three occasions: baseline, 30-min post-ingestion and between 65 to 75-min post-ingestion. Baseline vascular measurements [i.e., calf venous occlusion plethysmography, brachial artery flow-mediated dilation (FMD)], 30-min of continuous blood pressure (BP) and heart rate (HR) analysis, and follow-up vascular measurements beginning at 40-min post-ingestion were also performed.

Results: Humoral nitrate following RSE ingestion was significantly higher at 30- (+54 %; P = 0.039) and 65 to 75-min post-ingestion compared to baseline (+255 %, P < 0.001) and PBO at the same time points (P < 0.05). No significant changes in BP or HR occurred in either condition. Peak reactive hyperemia (RH) calf blood flow increased significantly (+13.7 %; P = 0.016) following RSE ingestion, whereas it decreased (-14.0 %; P = 0.008) following PBO ingestion. No significant differential FMD responses were detected (P > 0.05), though RH was decreased following the baseline measure in both conditions.

Conclusions: RSE significantly increased plasma nitrate 30-min post-ingestion, but acute microvascular (i.e., resistance vasculature) reactivity increases were isolated to the lower limb and no appreciable change in brachial artery FMD was observed.

Keywords: Amaranthus tricolor; Endothelial function; Flow-mediated dilation; Inorganic nitrate; Red spinach; Venous occlusion plethysmography.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Blood Flow Velocity / drug effects
  • Blood Flow Velocity / physiology
  • Blood Pressure / drug effects
  • Blood Pressure / physiology*
  • Brachial Artery / drug effects*
  • Brachial Artery / physiology
  • Female
  • Humans
  • Male
  • Nitrates / administration & dosage*
  • Nitrates / blood
  • Plant Extracts / administration & dosage
  • Plant Extracts / blood
  • Spinacia oleracea / chemistry*
  • Vascular Resistance / drug effects
  • Vascular Resistance / physiology*
  • Vasodilation / drug effects
  • Vasodilation / physiology*
  • Young Adult


  • Nitrates
  • Plant Extracts